0001235802-17-000157.txt : 20171006
0001235802-17-000157.hdr.sgml : 20171006
20171006164309
ACCESSION NUMBER: 0001235802-17-000157
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171004
FILED AS OF DATE: 20171006
DATE AS OF CHANGE: 20171006
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: PETRICK TIMOTHY B
CENTRAL INDEX KEY: 0001625443
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36814
FILM NUMBER: 171127863
MAIL ADDRESS:
STREET 1: C/O ENTELLUS MEDICAL, INC.
STREET 2: 3600 HOLLY LANE NORTH, SUITE 40
CITY: PLYMOUTH
STATE: MN
ZIP: 55447
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ENTELLUS MEDICAL INC
CENTRAL INDEX KEY: 0001374128
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 204627978
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3600 HOLLY LANE NORTH
STREET 2: SUITE 40
CITY: PLYMOUTH
STATE: MN
ZIP: 55447
BUSINESS PHONE: 763-463-1595
MAIL ADDRESS:
STREET 1: 3600 HOLLY LANE NORTH
STREET 2: SUITE 40
CITY: PLYMOUTH
STATE: MN
ZIP: 55447
4
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2017-10-04
0
0001374128
ENTELLUS MEDICAL INC
ENTL
0001625443
PETRICK TIMOTHY B
C/O ENTELLUS MEDICAL, INC.
3600 HOLLY LANE NORTH, SUITE 40
PLYMOUTH
MN
55447
0
1
0
0
VP, Research & Development
Common Stock, $0.001 par value
2017-10-04
4
S
0
2000
20.013
D
92385
D
These shares were sold under a pre-arranged sales instruction pursuant to Rule 10b5-1 under the Securities Exchange Act of 1934, as amended.
The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $20.00 to $20.05, inclusive. The reporting person undertakes to provide to Entellus Medical, Inc., any security holder of Entellus Medical, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in this footnote (2) to this Form 4.
Includes an aggregate of 933 shares acquired under the Entellus Medical, Inc. 2015 Employee Stock Purchase Plan on June 30, 2016, December 31, 2016 and June 30, 2017.
/s/ Brent Moen, attorney-in-fact
2017-10-06